PQRS/MOC Update

There have been several Physician Quality Reporting System (PQRS) program changes that have occurred due to the passing of the Affordable Care Act (ACA) legislation. The ACA has imposed PQRS payment penalties to begin in 2015. Up until 2015, there have been bonus incentives to participate in PQRS and the PQRS Maintenance of Certification (MOC) program. After 2014, CMS will no longer pay an incentive bonus for participating in PQRS Maintenance of Certification or pay an incentive bonus for participating in PQRS. Starting in 2015, a 1.5% penalty will be enacted for any providers who did not participate in PQRS for the 2013 reporting year according to the 2012 finalized Medicare Physician Fee Schedule rule. According to the 2014 finalized Medicare Physician Fee Schedule Rule, a 2% penalty will be enforced in 2016 to any providers who did not participate in the PQRS program for the 2014 reporting year.

Medicare Physician Quality Reporting System Incentives and Penalties

2013

0.5% (performance year for 2015 penalty)

2014

0.5% (performance year for 2016 penalty)

2015

-1.5%

2016

-2%

2017

-2%

2018 (Proposed)

-2%

APS will continue to make sure appropriate applicable PQRS codes are appended to all cases necessary and submitted to the carriers accordingly for all of our clients. If you have any questions regarding PQRS or the MOC program, please direct these to your APS Practice Manager.

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